facial wasting

Jan 6, 2008

Dear Sir/Madam

I would be very very grateful if you could answer this question for me. It's not so much Hiv related, but i have seen alot of talk on this website about facial wasting, and wondered if you could help me out. To cut a long story short, when i was 13 i got bells palsy, was put on steroids and told to do phsyio/massage for few wks. Basiaclly i only did the latter for two days and didn't continue the physio programme. Couple yrs later, friends and myself noticed a great deal of weight of my face, which got worse and worse. I went from a very full complexion to an aneroxic like complexion, i would like to add performing basic facial functions was stiff, and awkward. My theory is that the affected side of bells palsy wasn't sufficently strenghtened to optimum level, and the disue caused wasting and thinning of the muscle, hence the dramatic appearance in my face. I went to a neurologist who said no this did not happen, but after a year, i persuaded him to let me see a physiotherapist, who did an examination and said my facial muscle was weak. Any yrs on, from doing more intensive exercising like resistance, i,ve noticed so much muscle build around the orbital area, above the upper mouth and under the chin, the muscle increse is had made a big improvement. Fianlly my question is I always felt and still do that this facial wasting happend, the affected side has left volume than the right, but when i was seeing the neurologist when i was a teenager, i remember they did a CT scan, and to the best of your knowledge should or could a CT scan pick this up. I want to get to the bottom of this once and for all, and by comparing photos of me now to when i was a teen, well the photos back then are very much wasted, and if i had of listened to the doctor and did nothing I dread to think what my face would like today. I don't feel my doctor was entirely honest with me back then, and if a CT scan could pick this up, i would be very grateful if you could answer this question.

Thanking you
David

Response from Dr. Wohl

Dear David,

This is a site for questions related to HIV. Those of us who answer the questions are HIV doctors and we have little expertise related to your issues, which I think are quite distinct from those of persons living with this virus. I am sure your neurologist can provide a better response regarding the sensitivity of CT scans for facial muscle assessment.

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